| NPI | 1851730790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD458675) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036142786) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2017-06-28 |